Organization
CAROLINA PEDORTHIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN MARK ROGERS PEDORTHIST (OWNER)
(864) 583-4456
Entity
Organization
Contact information
Practice address
1000 N PINE ST, SUITE 19, SPARTANBURG, SC 29303-3151
(864) 583-4456
(864) 582-2728
Mailing address
1000 N PINE ST, SUITE 19, SPARTANBURG, SC 29303-3151
(864) 583-4456
(864) 582-2728
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
SC
Other
Enumeration date
12/17/2008
Last updated
03/27/2009
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